13 y/o female, risser stage 4, with 3 patellar dislocations of left knee in last 1 yr
Each patellar dislocations with minimal/no trauma/injury. Each episode resulted in patella relocation under anesthesia in local ER. Has had extensive PT. Beighton score 2/9
Exam - Right knee - normal, 50% lateral patella translation.
Left symptomatic knee - 3+ quadrant patella translation, + apprehension at both full extension and at 30 of flexion. Normal patella tilt, no tenderness to palpation at Femoral insertion of MPFL. Mild J sign on exam. Stable ligamentous exam. No effusion.
Xrays - patella alta - Blackburne peel index 1.2. CT scans - TTTG 1.7cm, 1.5 cm on contralateral right asymptomatic right knee. MRI - no Osteochondral injury. MRI - mild patellar translation. no acute MPFL injury. Mild trochlea dysplasia on MRI and CT scan, no crossover sign on XRays.
